Treatment of Leriche Syndrome with Absent Femoral Pulse in Acute Limb Ischemia from In Situ Native-Vessel Thrombosis

This protocol covers the acute presentation of Leriche syndrome with absent femoral pulse, acute-onset lower-extremity pain, and faint audible Doppler signals, arising from in situ native-vessel thrombosis. The patient has no recent surgery, and a long prior history of claudication is present. Acute limb ischemia (ALI) in this setting may result from thromboembolism, atheroembolism, or in situ thrombosis of the native artery.

The absent femoral pulse by palpation — combined with a long history of claudication and acute lower-extremity symptoms — defines this specific presentation and drives the immediate management approach.

Immediate anticoagulation therapy is a cornerstone of initial management in this setting, initiated without delay to limit thrombus progression while further treatment decisions are being made. The complete regimen and additional interventional considerations are detailed in the full protocol.